When children have ADHD (attention deficit hyperactivity disorder), their needs change from preschool through the teen years. In this guide, top behavioral experts provide parenting tips to help your ADHD child thrive in school and at home...

Mornings are hectic for parents who need to get children off to school – preferably with clean clothes, full tummies and appropriately loaded backpacks. But if your child has attention deficit hyperactivity disorder (ADHD), mornings can be really chaotic because the neurological disorder makes kids more impulsive, disorganized and easily distracted.

ADHD is often diagnosed during second or third grade but can show up in younger children. It usually lasts into adulthood. And keeping kids on track and thriving is a complex task for parents.

“You almost have to be super-parents,” says Mary Rooney, Ph.D., clinical psychologist at the ADHD and Disruptive Behavior Disorders Center of the Child Mind Institute in New York City.

“But there are ways to make it easier,” she says.

Whether your child is 6 or 16, read on for ADHD parenting tips from Rooney and other top behavior experts for kids in every age group.

Stage 1: ADHD in PreschoolCould my high-energy child have ADHD?

That’s a common question parents have, because nearly all preschoolers are sometimes impulsive, fidgety, cranky or inattentive, says Glen Elliott, M.D., Ph.D., chief psychiatrist and medical director at the Children’s Health Council in Palo Alto, Calif., and a clinical professor at Stanford University.

Consult a pediatrician when behavioral problems actually impair a child’s ability to learn, to socialize or to be safe, he advises. Signs include serious aggression, out-of-control impulsiveness – for example, children grab objects that are off-limits, can’t wait their turn – or engage in physically risky behavior.

If a preschooler has ADHD, “[our] primary focus is on helping parents improve their parenting skills,” Dr. Elliott adds.

One option he recommends: parent-child interaction therapy (PCIT), which teaches parents how to respond to their child’s behavior. During an eight-to-12-week period, parents and children play while a therapist observes behind a one-way mirror and coaches parents through an earpiece on what to say or do.

“It’s good for the relationship, and both the parent and child feel better about themselves,” Dr. Elliott says.

Ask your child’s school or a child psychologist whether this, or similar behavioral therapy, is available in your area.

Parenting tipsDr. Elliott recommends:

Offer positive feedback. When children obey rules, reward them with enthusiastic hugs or a few extra minutes with a favorite game.

Don’t reward bad behavior. When children act up in public, don’t give in to their demands to avoid embarrassment. For example, if your child throws a tantrum in a grocery store, leave immediately. Shop later when someone can baby-sit or the child agrees to behave.

Avoid excessive stimulation. Limit time with TV, computer and video games to no more than an hour daily to prevent sensory overload.

Prevent social burnout. Limit play dates to one friend at a time and end the session while the children are getting along. This leaves them wanting more, with something to look forward to.

Allow them to burn off energy. Schedule high-energy activity time daily in a controlled, safe environment. But avoid bedtime, because you want them relaxed and ready to fall asleep later.

Stage 2: ADHD in Early Elementary GradesThe peak time for an ADHD diagnosis is between ages 6 to 8 (grades 1 to 3). That’s when symptomatic behaviors – impulsiveness, hyperactivity and inability to pay attention – start disappearing among the child’s non-ADHD peers, Dr. Elliott says.

Your pediatrician may prescribe medication to control ADHD symptoms, but most experts, including Dr. Elliott, feel they do more harm than good at this age.

The drugs are powerful and suppress appetite and growth, and “they’re not helpful in kids this young very often,” Dr. Elliott says.

Instead, behavioral therapies are preferred, he says. Parents and teachers should set rules, offer rewards for good behavior and interact often with the child.

Parenting tips
Dr. Elliott recommends:

Be consistent. They’ll learn to follow rules, which will make life easier for them.

Praise them when they do follow the rules.

Before bedtime, lay out your child’s clothes and put everything they’ll need the next day in a backpack so they don’t have to make decisions in the morning.

Use a “chore chart” so a child can cross out or put a sticker on tasks – putting away clothes, doing homework, helping clear the table or brushing teeth – as they’re completed. Offer small prizes for completing at least 80% of chores in a day or week.

Take at least 10 minutes every day to build good relationships – for example, toss a ball, read a book, put a puzzle together, go for a walk or prepare dinner together. Don’t criticize or reprimand during this time and focus on just having fun together, Dr. Elliott advises.

Continue to limit media time to an hour or less a day.

Stage 3: ADHD in Later Elementary GradesDon’t expect ADHD children ages 9 to 12 to control themselves as well as their peers do, Rooney says. They lag about two years behind their peers in their “executive functioning” – the ability to control impulses or understand consequences of words or actions. That’s why parents must be patient.

If your child’s ADHD symptoms cause problems in school and at home, a pediatrician will probably prescribe medication such as methylphenidate, dextroamphetamine or atomoxetine, Rooney says. These drugs can be very effective in helping improve a child’s impulse control and ability to pay attention.

By fourth grade, kids have more homework, so continue to help them organize, complete and return it.

After school, allow them to decompress by playing and getting exercise, Rooney says. Then have a structured homework period in a set time and place.

Continue to limit TV and video games for kids ages 9 to 12, and delay giving them a cell phone as long as possible.

“ADHD children have a harder time transitioning off the screen because they get very engrossed, and it’s hard for them to shut their attention off,” Rooney explains.

Make it clear to your ADHD child that screen time is something to be earned, not an entitlement, she says.

“Interactive social activities and homework come first,” she adds.

Parenting tipsRooney recommends:

Check in weekly with your child’s teachers to make sure homework is being turned in and that there are no behavioral issues. If your school has a website where teachers post notices and homework, check it nightly to make sure all assignments are completed.

Provide backpack folders, including one marked “homework,” to help the child keep papers organized. Ask the teacher to make sure assignments are left in the homework folder at the end of the day.

Ask the teacher if you can borrow a second copy of any textbooks your child often needs for homework, just in case they don’t bring that book home.

Spend one-on-one time every day with your child just having fun.

Stage 4: ADHD in Middle SchoolHomework organization becomes even more important when ADHD children reach middle school. They now have more than one or two teachers, and it’s important to develop a working relationship with all of them, Rooney advises.

Kids are probably spending more time with computer games and social media, including cell phones. So keep an eye on them, she says. Let them help decide how to spend their time and how they should be rewarded for good behavior.

“Instead of charts and stickers that you use with younger kids, change [rewards] to things more appropriate for tweens,” Rooney says.

For example, if they complete homework with minimal fussing all week, they may earn a sleepover or an outing to a movie with friends. Kids are more likely to cooperate when there’s a reward waiting and if they took part deciding what it would be, she says.

Your pediatrician should carefully monitor any medication to see if adjustments are needed as your child goes through puberty.

Parenting tipsRooney recommends:

Teach your child to use a daily planner; it’s an essential organizational tool. Have your child fill out a schedule for each day.

Create a contract with your child in which certain behaviors, such as completing homework and chores, earn more independence and rewards.

Limit access to a cell phone. If your child has one, it should be turned off or put away during meals, homework and at bedtime.

Stage 5: ADHD in High SchoolParenting an ADHD teen is even more challenging than with a non-ADHD teen, because they’re likely to become more rebellious during these years, says Peter Jaksa, Ph.D., clinical director of ADD Centers of America in Chicago and a member of the scientific advisory board for ADDitude Magazine.

Don’t take the rebellion personally, he adds.

“It’s all part of growing up and developing their sense of self as an individual apart from their parents,” he says. “If you chill out, they will too.”

Parents must find a balance between the amount of structure teens need to be organized and one that they can tolerate, he says.

Although teens may have difficulty accepting parental rules, “they still have to have basic routines in place – otherwise, they’re lost,” Jaksa says.

Parenting tipsJaksa recommends:

Set and maintain realistic goals for yourself and your child. If more time is needed for tasks, pad the schedule.

Have good supports in place – for example, get tutoring help, find a counselor your child is comfortable talking with, set a regular sleep schedule and plan regular doctor visits to ensure the right medication and dosage.

Listen to your teen, and focus on solutions instead of problems.

Respect your child’s privacy and personal space. Monitor their behavior at home, but do it from a comfortable distance.

Increase privileges when your child demonstrates responsibility. These could include allowing an overnight stay at a friend’s house, attending a local concert with friends (with a chaperone) or borrowing the car once the teen has a driver’s license.

Involve your child in discussions about rules and routines. This encourages ADHD teens to comply and accept responsibility.

How Much Do You Know About Child ADHD?According to the Centers for Disease Control and Prevention, a little more than 9% of children in the U.S. are diagnosed with attention deficit hyperactivity disorder (ADHD). Boys face a higher risk than girls, being diagnosed more than 2 to 1. Take this quiz to test how much you know about ADHD.

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